{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T04:17:29Z","timestamp":1789359449984,"version":"build-2803163510"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2017,8,16]]},"abstract":"\n Background:<\/jats:title>\n Following anterior cruciate ligament (ACL) reconstruction, the mechanical loading of the tissues has a significant impact on tendon-to-bone healing. The purpose of this study was to determine the effect of the timing of the initiation of mechanical loading on healing of a tendon graft in a bone tunnel.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n ACL reconstruction using a flexor tendon autograft was performed in 56 mice randomized to 4 groups with differing times to initiation of postoperative mechanical loading: (1) immediate, (2) 5 days, (3) 10 days, or (4) 21 days following surgery. An external fixator was placed across the knee at the time of surgery and removed when mechanical loading was scheduled to commence. Following removal of the external fixator, animals were permitted free, unrestricted cage activity. All mice were killed on postoperative day 28, and tendon-to-bone healing was assessed by biomechanical testing, microcomputed tomography (micro-CT), and histological analysis.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The mean failure force (and standard deviation) of the reconstructed ACL at the time of sacrifice was highest for Group 2 (3.29 \u00b1 0.68 N) compared with Groups 1, 3, and 4 (p = 0.008). Micro-CT bone volume fraction was greatest for Group 2 in the femoral tunnel (p = 0.001), tibial tunnel (p = 0.063), and both bones (p < 0.001). Similarly, histological analysis demonstrated a narrower scar tissue interface and increased direct contact at the tendon-bone interface (p = 0.012) for Group 2.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Following ACL reconstruction, a defined period of immobilization without weight-bearing appears to improve biomechanical strength of the healing tendon-bone interface, while prolonged periods without mechanical load and motion decrease the ultimate load to failure in this murine model.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance:<\/jats:title>\n The ideal period of restricted weight-bearing and motion following ACL reconstruction remains undefined. In a murine model, improved healing was noted for animals immobilized for a brief period of 5 days. This work may serve as an initial step in determining the ideal time period in a clinical population.<\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.17.00133","type":"journal-article","created":{"date-parts":[[2017,8,16]],"date-time":"2017-08-16T15:40:37Z","timestamp":1502898037000},"page":"1382-1391","source":"Crossref","is-referenced-by-count":58,"title":["Timing of Postoperative Mechanical Loading Affects Healing Following Anterior Cruciate Ligament Reconstruction"],"prefix":"10.2106","volume":"99","author":[{"given":"Christopher L.","family":"Camp","sequence":"first","affiliation":[{"name":"Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Lebaschi","sequence":"additional","affiliation":[{"name":"Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang-Ting","family":"Cong","sequence":"additional","affiliation":[{"name":"Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Album","sequence":"additional","affiliation":[{"name":"Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Carballo","sequence":"additional","affiliation":[{"name":"Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang-Hua","family":"Deng","sequence":"additional","affiliation":[{"name":"Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-9880","authenticated-orcid":false,"given":"Scott A.","family":"Rodeo","sequence":"additional","affiliation":[{"name":"Tissue Engineering, Regeneration, and Repair Program, Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"5","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"283","DOI":"10.5435\/JAAOS-D-13-00183","article-title":"Return to play following anterior cruciate ligament reconstruction","volume":"23","author":"Ellman","year":"2015","journal-title":"J Am Acad Orthop Surg."},{"issue":"11","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1177\/0363546510373876","article-title":"Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up","volume":"38","author":"Oiestad","year":"2010","journal-title":"Am J Sports Med."},{"issue":"1","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1177\/0363546515611886","article-title":"Comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction: a 15-year follow-up of a randomized controlled trial","volume":"44","author":"Webster","year":"2016","journal-title":"Am J Sports Med."},{"issue":"1","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.arthro.2015.07.027","article-title":"Autograft versus allograft in anterior cruciate ligament reconstruction: a meta-analysis of randomized controlled trials and systematic review of overlapping systematic reviews","volume":"32","author":"Zeng","year":"2016","journal-title":"Arthroscopy."},{"issue":"3","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1177\/036354659402200309","article-title":"An analysis of autograft fixation after anterior cruciate ligament reconstruction in a rabbit model","volume":"22","author":"Grana","year":"1994","journal-title":"Am J Sports Med."},{"issue":"12","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.2106\/00004623-199312000-00009","article-title":"Tendon-healing in a bone tunnel. 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